Provider Demographics
NPI:1083402994
Name:PARSAPOUR, SAMAREH TAHERI
Entity type:Individual
Prefix:MS
First Name:SAMAREH
Middle Name:TAHERI
Last Name:PARSAPOUR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 RANDON TER
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2635
Mailing Address - Country:US
Mailing Address - Phone:281-935-2764
Mailing Address - Fax:
Practice Address - Street 1:305 WAYMONT CT
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3566
Practice Address - Country:US
Practice Address - Phone:954-850-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician